Cavic-C Plus

Indications

This preparation is a combined calcium, vitamin C and vitamin D3 supplement. It is used in the following situations:

• As an additional treatment alongside specific therapy for osteoporosis, a condition in which the bones become thin and fragile
• When the need for calcium, vitamin C and vitamin D is increased, such as in pregnancy, breastfeeding, periods of rapid growth in childhood and adolescence, and in old age
• In osteomalacia, a softening of the bones caused by poor mineralisation
• For the prevention and treatment of calcium deficiency and vitamin D deficiency, particularly in housebound and hospitalised elderly people
• As a supportive treatment in cold and influenza
• In postmenopausal syndromes
• In premenstrual symptoms
• In high body temperature
• As an alkalising agent in conditions with systemic acidosis, meaning too much acid in the body

Pharmacology

Calcium gluconate is the gluconate salt of calcium. Calcium is a mineral needed for normal nerve, muscle and heart function, and when taken by mouth this salt helps maintain calcium balance and prevent bone loss. It may also have a protective role against colon and certain other cancers.

Calcium carbonate obtained from coral has a chemical structure very similar to that of human bone, and coral calcium is comparable to other sources while allowing better absorption. Vitamin D3 helps the body absorb calcium from the gastrointestinal tract and keeps calcium balance steady. In humans calcium is used almost entirely to correct deficiency, because an adequate blood calcium level is essential to many body functions and the body cannot tolerate a shortage even for a short period.

Vitamin C is an essential part of the diet because the human body cannot make it. It is a powerful reducing agent, plays an important part in the body response to stress and is important in defence against infection.

Vitamin D is also essential for healthy bones, as it helps calcium absorption from the gastrointestinal tract and stimulates bone formation. Clinical studies show that calcium and vitamin D work together on bone growth and in the prevention of osteoporosis and fractures.

Dosage & Administration

• Adolescents and adults: 1 effervescent tablet per day.
• Children: half an effervescent tablet per day.
• Infants: as prescribed by the physician.
• Dissolve one tablet in a glass of water before taking it.

Interaction

The risk of a high blood calcium level should be considered in patients taking thiazide diuretics, because these medicines reduce the amount of calcium passed in the urine. A high blood calcium level must be avoided in patients taking digitalis. Some foods, for example those containing oxalic acid, phosphate or phytinic acid, may reduce calcium absorption. Treatment with phenytoin or barbiturates can lessen the effect of vitamin D by changing how it is activated in the body. The effect of digitalis and other cardiac glycosides may be increased when calcium is taken by mouth together with vitamin D. Calcium salts may reduce the absorption of thyroxine, bisphosphonates, sodium fluoride, quinolone or tetracycline antibiotics and iron, so a gap of at least 4 hours before taking the calcium is advisable.

Contraindications

It must not be used in a high blood calcium level caused by myeloma, bone metastases or other malignant bone disease, in sarcoidosis, in primary hyperparathyroidism or in vitamin D overdosage. It is also contraindicated in severe kidney failure and in hypersensitivity to any ingredient of the tablet.

Side Effects

Calcium supplements have rarely caused mild gastrointestinal upset such as constipation, flatulence, nausea, stomach pain and diarrhoea. Occasional skin rash has been reported after vitamin D supplements. A raised calcium level in the urine, and in rare cases a raised blood calcium level, have been seen during long-term treatment with high doses of vitamin D.

Pregnancy & Lactation

During pregnancy and breastfeeding this supplement should always be taken under the direction of a physician. Requirements for calcium and vitamin D are higher at these times, but when deciding on the dose, allowance should be made for the amounts obtained from other sources. Overdoses of vitamin D have caused harm to the developing young in pregnant animals. Vitamin D and its metabolites pass into breast milk.

Precautions & Warnings

Patients with mild to moderate kidney failure or a mildly raised urinary calcium level should be supervised carefully, with periodic checks of blood calcium levels and urinary calcium excretion. In patients with a history of kidney stones, urinary calcium should be measured to rule out excessive calcium in the urine. With long-term treatment it is advisable to monitor blood and urinary calcium levels and kidney function, and to reduce or temporarily stop treatment if urinary calcium exceeds 7.5 mmol in 24 hours. Allowance should be made for calcium and vitamin D taken from other sources.

Overdose Effects

The most serious result of acute or chronic overdose is a high blood calcium level due to vitamin D toxicity. Symptoms include nausea, vomiting, passing large amounts of urine and constipation. Repeated overdoses can lead to calcium deposits in blood vessels and organs. Treatment consists of stopping all intake of calcium and vitamin D and giving fluids.

Storage Conditions

Store in a cool and dry place, protected from light and moisture. Keep the container tightly closed and keep out of the reach of children.